Questions: Provide your responses in the boxes below each question.
| Questions: Provide your responses in the boxes below each question. | |||||||||||
| Question 1: | Explain the pathophysiology of Gestational Diabetes Mellitus (GDM).
Include the following in your answer:
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Comment:
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| Question 2: | Nala is diagnosed with GDM by an endocrinologist. She is on
NovoRapid ®FlexPen® pre-meals:4 Units, 6 Units and 6 Units.
List five (5) points for including Insulin storage and injection techniques.
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Comment:
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| Question 3: | Whilst maternal blood glucose levels usually return to normal
after birth, there is an increased risk for the mother developing Type 2 Diabetes Mellitus in the future.
Outline five (5) education strategies you would implement to educate Nala and her family/carer to decrease Nala’s risk of developing Type 2 Diabetes Mellitus (T2DM). |
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Comment:
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| Question 4: | Aged 35 years, Nala’s weight has increased to 87 kgs, she leads a sedentary lifestyle, consumes a high saturated fat/ high salt diet and smokes 10 cigarettes per day. She visited her GP complaining of fatigue, recurrent vaginal thrush and itchy skin. Nala’s GP suspects that she may have developed T2DM.
The GP orders Nala an OGTT to confirm the clinical diagnosis.
Describe the preparation and procedure for an OGTT.
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| Question 5: | Describe the role and the relevant services for each health practitioner (see Table below) if Nala has been diagnosed with T2DM.
Endocrinologist, ophthalmologist, GP and psychologist
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| Question 6: | The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government commenced in 1987.
Diabetes Australia administers NDSS.
List five (5) services that NDSS Provides.
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Comment:
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GDM Case Study
Nala is a 27-year-old who is identified as Aboriginal and Torres Strait Islander. She is in her 20th week of pregnancy. This is Marilyn’s first pregnancy. Nala has a past medical history of polycystic ovaries (symptomatic treatment) and both of her parents have T2DM. She weighs 84 kgs, is 162 cms tall and has a BMI of 32. She works part-time as a call-operator and otherwise has a sedentary lifestyle. Nala does not participate in any physical exercise and her diet consists almost entirely of fried food, sugary soft drinks and dessertbreads. Nala eats very little fruit and vegetables, which are either canned or frozen.
At 24 weeks’gestation, Nala underwent an Oral Glucose ToleranceTest (OGTT) with the following results:
2-hour Oral Glucose Tolerance Test (OGTT) – 75g glucoseload
| Time | Venous Plasma Glucose |
| Fasting level | 7.9 mmol/L |
| 2 hours post glucose load | 13.2 mmol/L |
Nala also had her blood pressure monitored and a urinalysis with the following results.
Blood pressure: 160/95.
Urinalysis: protein ++, glucose ++, ketones -ve, blood -ve, bilirubin -ve, nitrites -ve, leukocytes -ve, SG 1.010, pH 7.0.
Nala has also been complaining of headaches and swollen hands and feet. She has been diagnosedwith gestational diabetesmellitus complicated by pre-eclampsia.
In the person/family/carer own words, answer the following questions relating to Nala’s journey through Gestational Diabetes Mellitus (GDM) and T2DM.
Australian references please
Complete Answer:
